I have (too) much to say about this topic, but, sadly, nothing new. I start with the premise that what is found within the arts and humanities is deeply important to the work and personhood of those who practice medicine. It is not “extra”; it is not “fluff.” It is essential. I have found little resistance to this notion. Resistance comes when various forms of support (yes, money in particular) and curricular time are requested. Such resistance is found among administrators, faculty, and students alike.

While certain arts/humanities courses or activities may be entertaining, entertainment is not the primary objective of these offerings. I have long thought that the responses of students to attempts to bring the arts and humanities into medical education vary from approval (sometimes enthusiastic) to indifference/confusion to rejection (sometimes enthusiastic). In my experience, each accounts for about 1/3 of the students in any particular class year. For the first group of students, the infusion of humanities into their medical school lives is a treat, and it supports and nurtures what they already know, that the human aspects of medicine are crucial. For the second group, with those unsure of what’s going on here, the arts and humanities may remind students of why they chose medicine and, in a way, protect them from forces (say, in the “hidden curriculum”) that would have them forget. The third group includes the students I would most like to reach, especially if they are headed for clinical medicine. For them in particular, we must be creative with our curricular methods.

As you likely know, there are two medical curricular approaches to engaging the arts/humanities – infusion, and elective courses. Each has its advantages and disadvantages. Briefly:

Infusion: has the advantage that everyone is exposed; it has the cachet of being within the “required” core curriculum. However, such offerings perforce risk being shallow add-ons with insufficient time allotted, sometimes “taught” by faculty unfamiliar with such subject matter or, worse, unenthusiastic about it.

Elective courses: have the advantage of allowing in-depth consideration/discussion of topics. The all-too-common problems include lack of funding and, more seriously, attracting only those students who already appreciate their value.

At our medical program (the UCB – UC San Francisco Joint Medical Program), where Marilyn McEntyre and I teach, we have tried both, each with partial success. (I, and I feel certain Marilyn, and others in this discussion group, would be happy to talk with anyone interested in our attempts.)

One last general comment… Some, not only in medicine, have the false notion that science is “hard” and really important, while the arts and humanities are “soft” and, well, pretty easy-breezy - you know, whatever; like, take a poem, what it means is not pindown-able; it could mean anything. By implication, you have to be really smart to be a scientist; but, not so much so in the arts/humanities. For anyone who harbors those thoughts, even maybe a little, unconsciously, I highly recommend a recent article in the Washington Post by Satyan Linus Devadoss, a UCSD mathematician titled “A Math Problem for Pi Day” (washingtonpost.com/opinions/a-...). In it, he claims that when people hear what he does, they inevitably say, “you must be smart;” and, while he likes that, he wonders if he’d receive a similar reaction if he were a historian, a writer, an artist. His answer, “Not likely.” Why? Because of the “unspoken spectrum of smart in society … art < literature < history < economics < biology < math.” He goes on to say that “this assumption is not only flawed, but completely backward.” A good read.

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